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result sql = Introduction and Proliferation of Multidrug-Resistant Streptococcus pneumoniae Serotype 19A Clones That Cause Acute Otitis Media in an Unvaccinated Population.

Introduction and Proliferation of Multidrug-Resistant Streptococcus pneumoniae Serotype 19A Clones That Cause Acute Otitis Media in an Unvaccinated Population.

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char = o;code = 111
char = c;code = 99
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char = ;code = 32
char = s;code = 115
char = e;code = 101
char = q;code = 113
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char = e;code = 101
char = n;code = 110
char = c;code = 99
char = e;code = 101
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char = t;code = 116
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char = p;code = 112
char = i;code = 105
char = n;code = 110
char = g;code = 103
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char = o;code = 111
char = f;code = 102
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = p;code = 112
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
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char = i;code = 105
char = s;code = 115
char = o;code = 111
char = l;code = 108
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = s;code = 115
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char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = m;code = 109
char = p;code = 112
char = a;code = 97
char = r;code = 114
char = e;code = 101
char = d;code = 100
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char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = a;code = 97
char = t;code = 116
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char = o;code = 111
char = f;code = 102
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = n;code = 110
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = c;code = 99
char = l;code = 108
char = o;code = 111
char = n;code = 110
char = e;code = 101
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = R;code = 82
char = e;code = 101
char = s;code = 115
char = u;code = 117
char = l;code = 108
char = t;code = 116
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = S;code = 83
char = p;code = 112
char = 1;code = 49
char = 9;code = 57
char = A;code = 65
char = ;code = 32
char = c;code = 99
char = a;code = 97
char = u;code = 117
char = s;code = 115
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = 4;code = 52
char = 3;code = 51
char = 8;code = 56
char = ;code = 32
char = (;code = 40
char = 9;code = 57
char = .;code = 46
char = 8;code = 56
char = %;code = 37
char = );code = 41
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = 4;code = 52
char = 4;code = 52
char = 4;code = 52
char = 9;code = 57
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char = p;code = 112
char = n;code = 110
char = e;code = 101
char = u;code = 117
char = m;code = 109
char = o;code = 111
char = c;code = 99
char = o;code = 111
char = c;code = 99
char = c;code = 99
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = A;code = 65
char = O;code = 79
char = M;code = 77
char = ;code = 32
char = e;code = 101
char = p;code = 112
char = i;code = 105
char = s;code = 115
char = o;code = 111
char = d;code = 100
char = e;code = 101
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = c;code = 99
char = r;code = 114
char = e;code = 101
char = a;code = 97
char = s;code = 115
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = b;code = 98
char = y;code = 121
char = ;code = 32
char = 6;code = 54
char = 3;code = 51
char = .;code = 46
char = 1;code = 49
char = %;code = 37
char = ;code = 32
char = f;code = 102
char = r;code = 114
char = o;code = 111
char = m;code = 109
char = ;code = 32
char = 1;code = 49
char = 9;code = 57
char = 9;code = 57
char = 9;code = 57
char = -;code = 45
char = 2;code = 50
char = 0;code = 48
char = 0;code = 48
char = 1;code = 49
char = ;code = 32
char = (;code = 40
char = m;code = 109
char = e;code = 101
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = +;code = 43
char = /;code = 47
char = -;code = 45
char = ;code = 32
char = S;code = 83
char = D;code = 68
char = ,;code = 44
char = ;code = 32
char = 8;code = 56
char = .;code = 46
char = 4;code = 52
char = %;code = 37
char = ;code = 32
char = +;code = 43
char = /;code = 47
char = -;code = 45
char = ;code = 32
char = 0;code = 48
char = .;code = 46
char = 8;code = 56
char = %;code = 37
char = );code = 41
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = 2;code = 50
char = 0;code = 48
char = 0;code = 48
char = 4;code = 52
char = -;code = 45
char = 2;code = 50
char = 0;code = 48
char = 0;code = 48
char = 6;code = 54
char = ;code = 32
char = (;code = 40
char = m;code = 109
char = e;code = 101
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = +;code = 43
char = /;code = 47
char = -;code = 45
char = ;code = 32
char = S;code = 83
char = D;code = 68
char = ,;code = 44
char = ;code = 32
char = 1;code = 49
char = 3;code = 51
char = .;code = 46
char = 7;code = 55
char = %;code = 37
char = ;code = 32
char = +;code = 43
char = /;code = 47
char = -;code = 45
char = ;code = 32
char = 0;code = 48
char = .;code = 46
char = 9;code = 57
char = %;code = 37
char = );code = 41
char = ;code = 32
char = a;code = 97
char = m;code = 109
char = o;code = 111
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = B;code = 66
char = e;code = 101
char = d;code = 100
char = o;code = 111
char = u;code = 117
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = c;code = 99
char = h;code = 104
char = i;code = 105
char = l;code = 108
char = d;code = 100
char = r;code = 114
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char = n;code = 110
char = ,;code = 44
char = ;code = 32
char = w;code = 119
char = h;code = 104
char = o;code = 111
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = c;code = 99
char = h;code = 104
char = a;code = 97
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = i;code = 105
char = z;code = 122
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = b;code = 98
char = y;code = 121
char = ;code = 32
char = o;code = 111
char = v;code = 118
char = e;code = 101
char = r;code = 114
char = c;code = 99
char = r;code = 114
char = o;code = 111
char = w;code = 119
char = d;code = 100
char = i;code = 105
char = n;code = 110
char = g;code = 103
char = ;code = 32
char = a;code = 97
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char = d;code = 100
char = ;code = 32
char = h;code = 104
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = b;code = 98
char = i;code = 105
char = o;code = 111
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = u;code = 117
char = s;code = 115
char = e;code = 101
char = .;code = 46
char = ;code = 32
char = P;code = 80
char = e;code = 101
char = n;code = 110
char = i;code = 105
char = c;code = 99
char = i;code = 105
char = l;code = 108
char = l;code = 108
char = i;code = 105
char = n;code = 110
char = ,;code = 44
char = ;code = 32
char = e;code = 101
char = r;code = 114
char = y;code = 121
char = t;code = 116
char = h;code = 104
char = r;code = 114
char = o;code = 111
char = m;code = 109
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char = c;code = 99
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char = n;code = 110
char = ,;code = 44
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
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char = m;code = 109
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char = l;code = 108
char = t;code = 116
char = i;code = 105
char = d;code = 100
char = r;code = 114
char = u;code = 117
char = g;code = 103
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = a;code = 97
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char = c;code = 99
char = e;code = 101
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char = i;code = 105
char = n;code = 110
char = c;code = 99
char = r;code = 114
char = e;code = 101
char = a;code = 97
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char = e;code = 101
char = d;code = 100
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char = f;code = 102
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char = o;code = 111
char = m;code = 109
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char = <;code = 60
char = 1;code = 49
char = 0;code = 48
char = %;code = 37
char = ;code = 32
char = t;code = 116
char = o;code = 111
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char = 7;code = 55
char = 8;code = 56
char = .;code = 46
char = 6;code = 54
char = %;code = 37
char = ,;code = 44
char = ;code = 32
char = 5;code = 53
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char = .;code = 46
char = 0;code = 48
char = %;code = 37
char = ,;code = 44
char = ;code = 32
char = a;code = 97
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char = d;code = 100
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char = .;code = 46
char = 0;code = 48
char = %;code = 37
char = ,;code = 44
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char = r;code = 114
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char = s;code = 115
char = p;code = 112
char = e;code = 101
char = c;code = 99
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char = i;code = 105
char = v;code = 118
char = e;code = 101
char = l;code = 108
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char = (;code = 40
char = [;code = 91
char = F;code = 70
char = o;code = 111
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char = m;code = 109
char = u;code = 117
char = l;code = 108
char = a;code = 97
char = :;code = 58
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char = e;code = 101
char = e;code = 101
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char = e;code = 101
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char = );code = 41
char = ,;code = 44
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char = a;code = 97
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char = d;code = 100
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char = a;code = 97
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char = o;code = 111
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char = a;code = 97
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char = d;code = 100
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char = t;code = 116
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char = t;code = 116
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char = d;code = 100
char = u;code = 117
char = c;code = 99
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char = i;code = 105
char = o;code = 111
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char = ;code = 32
char = a;code = 97
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char = o;code = 111
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char = f;code = 102
char = e;code = 101
char = r;code = 114
char = a;code = 97
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char = o;code = 111
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char = o;code = 111
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char = ;code = 32
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char = m;code = 109
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char = l;code = 108
char = t;code = 116
char = i;code = 105
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char = g;code = 103
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char = s;code = 115
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char = s;code = 115
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char = a;code = 97
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char = c;code = 99
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char = o;code = 111
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char = e;code = 101
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char = t;code = 116
char = h;code = 104
char = a;code = 97
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char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
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char = t;code = 116
char = ;code = 32
char = p;code = 112
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char = e;code = 101
char = v;code = 118
char = i;code = 105
char = o;code = 111
char = u;code = 117
char = s;code = 115
char = l;code = 108
char = y;code = 121
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char = a;code = 97
char = s;code = 115
char = s;code = 115
char = o;code = 111
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char = i;code = 105
char = a;code = 97
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char = e;code = 101
char = d;code = 100
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char = i;code = 105
char = t;code = 116
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char = m;code = 109
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char = l;code = 108
char = t;code = 116
char = i;code = 105
char = d;code = 100
char = r;code = 114
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char = g;code = 103
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char = s;code = 115
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char = s;code = 115
char = t;code = 116
char = a;code = 97
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char = e;code = 101
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = i;code = 105
char = s;code = 115
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char = w;code = 119
char = a;code = 97
char = s;code = 115
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char = p;code = 112
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char = r;code = 114
char = a;code = 97
char = l;code = 108
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char = s;code = 115
char = o;code = 111
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char = q;code = 113
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char = a;code = 97
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char = o;code = 111
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char = i;code = 105
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char = .;code = 46
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char = C;code = 67
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char = c;code = 99
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char = u;code = 117
char = s;code = 115
char = i;code = 105
char = o;code = 111
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char = s;code = 115
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
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char = i;code = 105
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char = o;code = 111
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char = m;code = 109
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char = g;code = 103
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char = s;code = 115
char = t;code = 116
char = a;code = 97
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char = S;code = 83
char = p;code = 112
char = 1;code = 49
char = 9;code = 57
char = A;code = 65
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char = o;code = 111
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char = r;code = 114
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char = f;code = 102
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char = o;code = 111
char = n;code = 110
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char = o;code = 111
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char = ;code = 32
char = P;code = 80
char = C;code = 67
char = V;code = 86
char = 7;code = 55
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
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char = i;code = 105
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char = a;code = 97
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char = i;code = 105
char = n;code = 110
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char = p;code = 112
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char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
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char = n;code = 110
char = t;code = 116
char = i;code = 105
char = b;code = 98
char = i;code = 105
char = o;code = 111
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = -;code = 45
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char = i;code = 105
char = s;code = 115
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char = a;code = 97
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = S;code = 83
char = p;code = 112
char = 1;code = 49
char = 9;code = 57
char = A;code = 65
char = ;code = 32
char = s;code = 115
char = u;code = 117
char = g;code = 103
char = g;code = 103
char = e;code = 101
char = s;code = 115
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = a;code = 97
char = t;code = 116
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = b;code = 98
char = i;code = 105
char = o;code = 111
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = u;code = 117
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = p;code = 112
char = l;code = 108
char = a;code = 97
char = y;code = 121
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = ;code = 32
char = i;code = 105
char = m;code = 109
char = p;code = 112
char = o;code = 111
char = r;code = 114
char = t;code = 116
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = r;code = 114
char = o;code = 111
char = l;code = 108
char = e;code = 101
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = c;code = 99
char = o;code = 111
char = m;code = 109
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char = u;code = 117
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result sql = Background. Introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in the United States in 2000 was temporally associated with an increase in the incidence of disease caused by Streptococcus pneumoniae serotype 19A (Sp19A) and with increasing drug resistance within this serotype. A causative role of PCV7 was speculated. We prospectively studied the dynamics of acute otitis media (AOM) caused by Sp19A in southern Israel before the introduction of PCV7. Methods. AOM in children <5 years old undergoing tympanocentesis during 1999-2006 was studied. Antibiotic prescriptions for approximately 20% of children <5 years old were recorded. Sp19A isolates were studied for antibiotic-resistance and pulsed-field gel electrophoresis patterns; multilocus sequence typing of representative isolates was compared with that of international clones. Results. Sp19A caused 438 (9.8%) of 4449 pneumococcal AOM episodes, increasing by 63.1% from 1999-2001 (mean +/- SD, 8.4% +/- 0.8%) to 2004-2006 (mean +/- SD, 13.7% +/- 0.9%) among Bedouin children, who were characterized by overcrowding and high antibiotic use. Penicillin, erythromycin, and multidrug resistance increased from <10% to 78.6%, 50.0%, and 50.0%, respectively ([Formula: see text]), and was associated with the introduction and proliferation of 2 multidrug-resistant clones that were not previously associated with multidrug resistance. This was temporally associated with the introduction of and rapid increase in azithromycin use and the frequent use of oral cephalosporins. Conclusions. The introduction and proliferation of multidrug-resistant Sp19A occurred before the introduction of PCV7. The increasing proportion of antibiotic-resistant Sp19A suggests that antibiotic use plays an important role in the community.

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